Scaling and Root Planing Effect to mRNA Expression of Matrix Metalloproteinase-9 and Periodontal Clinical Parameters on Chronic Periodontitis

Abstract Objective: To evaluate the relationship between the mRNA transcription level of Matrix Metalloproteinase-9 (MMP-9) and the selected clinical periodontal healing at one month of scaling and root planing. Material and Methods: A total of six chronic periodontitis patients and one periodontally healthy subject were recruited. The gingival crevicular fluid was collected from all subjects, and the expression level of MMP-9 mRNA was measured by quantitative real-time PCR. Pocket depth, papilla bleeding index, and clinical attachment loss were measured on day 1 at baseline and day 30. Scaling and root planing was performed on day 1. Data were analyzed using SPSS 22.0 software Results: In comparison to the control, periodontal clinical parameters in the treatment group were significantly reduced after scaling and root planing. MMP-9 mRNA expression did not show a significant change after the 30th day. A weak correlation was noted between the MMP-9 mRNA transcription level and the changed PBI measurement Conclusion: Scaling and root planing is clinically effective for chronic periodontitis with a 4-6 mm pocket, whereas the expression of MMP-9 mRNA was not altered. Further studies with a more extended observation period are needed to confirm or reject the present findings.

Evaluation of the relative efficacy of an alloplast used alone and in conjunction with an osteoclast inhibitor in the treatment of human periodontal infrabony defects: A clinical and radiological study.

Background: Mucoperiosteal flap surgery stimulates varying amounts of alveolar bone loss due to accelerated osteoclastic activity [Regional Accelerated Phenomenon (RAP)]. Alendronate sodium inhibits osteoclastic activity and is thought to result in a net increase in osteoblastic activity. We undertook a preliminary study evaluating the effect of adjunctive use of topically delivered bisphosphonate alendronate (ALN) along with regenerative bone graft material in the treatment of periodontal infrabony defects. Materials and Methods: Fifteen patients with two-walled or three-walled infrabony defects were selected. In each patient, the infrabony defect of one side of arch was designated as group A (control site) and received hydroxyapatite (HA) bone graft material, while the infrabony defect on the contralateral side of same arch was designated as group B (test site) and received HA + 200 μg drug solution of ALN. Results: Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level and linear bone fill at the end of 24 weeks. Comparative evaluation between the study groups revealed a statistically nonsignificant reduction in probing depth (P=0.128 NS ) and mean gain in attachment level (P=0.218 NS ). However, there was a statistically significant gain in linear bone fill (P=0.040*) in group B as compared to group A. Conclusions: The results suggest that use of ALN along with graft material led to enhanced linear bone fill at the surgical site. This research provides a clue that bone-targeting properties of bisphosphonates can be harnessed along with regenerative materials to potentiate osseous regeneration.

Influence of dental exposure to oral environment on smear layer removal and collagen exhibition after using different conditioning agents

Although in vitro studies have shown encouraging results for root surface conditioning with demineralizing agents, in vivo studies have failed to show its benefits in periodontal healing. This can be attributed to several factors, among which, the hypermineralization of dental surface. Therefore, this in vitro study compared, using scanning electron microscopy (SEM), the effect of root surface conditioning with different conditioners (1% and 25% citric acid, 24% EDTA and 50 mg/mL tetracycline hydrochloride) in impacted teeth and in teeth that had their roots exposed to the oral environment. One trained examiner assessed the SEM micrographs using a root surface modification index. There was a tendency of more root surface modification in the group of impacted teeth, suggesting that the degree of root mineralization influences its chemical demineralization.

Apesar de estudos in vitro terem demonstrado resultados favoráveis ao condicionamento da superfície radicular com agentes desmineralizantes, estudos in vivo não mostraram seus benefícios na cicatrização periodontal. Isto pode ser atribuído a vários fatores, entre os quais, a hipermineralização da superfície dental. Portanto, este estudo in vitro comparou, usando microscopia eletrônica de varredura, o efeito do condicionamento da superfície radicular com diferentes condicionadores (1% e 25% de ácido cítrico, EDTA 24% e 50 mg/mL de cloridrato de tetraciclina) em dentes impactados e dentes que tinham suas raízes expostas ao meio bucal. Um examinador treinado avaliou as microscopias eletrônicas de varredura utilizando um índice de modificação da superfície radicular. Houve uma tendência de maior modificação da superfície radicular no grupo de dentes impactados, sugerindo que o grau de mineralização da raiz influencia a sua desmineralização química.

E-cadherin and CD1a expression in gingival epithelium in periodontal health, disease and post-treatment.

Background: Epithelial integrity is important for maintenance of periodontal health. It is not fully known if non-surgical periodontal therapy is capable of recreating the epithelial barrier in its functional state. Patients and Methods: Sixty-five patients (31 males and 34 females) were included in the study. They were divided into group A (healthy gingiva 16 patients), group B (gingivitis 17 patients), group C (periodontitis 17 patients), and group D (post-treatment 15 patients). Gingival samples were collected and immunohistochemical study was done using E-cadherin and CD1a antibody. Statistical analysis was done using analysis of variance (ANOVA), followed by Tukey-Kramer multiple comparison test for CD1a and Tukey's highly significant difference (HSD) test for E-cadherin. Result: There was a statistically significant difference (P<0.001) in the expression of E-cadherin between healthy (1.846±0.555), gingivitis (1.100±0.994), and periodontitis group (0.700±0.483). Similarly, there was a statistically significant difference (P<0.001) in the expression of CD1a between healthy (75.70±3.09), gingivitis (42.53±3.09), and periodontitis group (29.07±3.08). However, the expression of E-cadherin (1.242±0.653) and CD1a in post-treatment samples (52.18±2.90) was lower with no statistically significant difference when compared to health. Discussion: The significant reduction in E-cadherin and CD1a levels in periodontal disease when compared to health could possibly be a result of invasion by the periodontopathogens and its subsequent sequel. Although, the post-treatment samples showed significant improvement when compared to disease, the reduction in E-cadherin and CD1a levels when compared to gingival health suggests that the epithelial barrier was not yet fully established in its functional state.

Partial expression of Papillon-Lefèvre Syndrome.

Papillon- Lefèvre Syndrome (PLS) is a rare autosomal recessive trait, which is transmitted with an estimated frequency of one to four per million individuals. It is characterized by palmar plantar keratosis and severe early-onset periodontitis affecting both deciduous and permanent dentition. In this report, we present clinical, microbiological and leukocyte function test findings of a thirty-five year-old patient with symptoms typical of Papillon-Lefèvre Syndrome except for premature loss of deciduous and permanent dentition. The patient exhibited palmar plantar keratosis and an isolated, moderately deep periodontal pocket in the third quadrant. No anaerobic bacteria were isolated from the plaque culture. The neutrophil function test revealed defective chemotaxis and phagocytosis while intracellular killing and respiratory burst were normal.

Free gingival graft in the treatment of class III gingival recession.

AIM: The purpose of this study was to assess the success and predictability of root coverage and esthetics obtained with free gingival grafts (FGGs) in the treatment of early class III gingival recessions for a period of 12 months. MATERIALS AND METHODS: Ten patients contributed to 12 sites, each with early class III recession with interdental bone loss < or = 4 mm from cemento enamel junction(CEJ). Clinical parameters recorded at baseline and at 1, 6, and 12 months were probing depth (PD), recession depth (RD), recession width (RW), and clinical attachment level (CAL). RESULTS: Reduction of recession resulted in a significant gain in CAL and PD at the end of 12 months. A statistically significant mean root coverage of 41.25 +/- 21.07% was obtained at the end of 12 months. A statistically significant improvement in Visual Analog Scale score was seen after a 12-month follow-up period. CONCLUSION: In a south Indian population, early class III gingival recessions treated with FGG procedures resulted in 40-50% root coverage with fairly acceptable esthetics.

Healing of periodontal flaps when closed with silk sutures and N-butyl cyanoacrylate: a clinical and histological study.

BACKGROUND: The closure of the periodontal flaps post-surgery is a necessity for attainment of a primary union between the flap margins and the establishment of a healthy dentogingival junction. N-butyl cyanoacrylate is a tissue adhesive, which can be used for the closure of the incised wounds to overcome the problems associated with conventional suture materials like silk. OBJECTIVE: The present study was carried out to assess the healing of the periodontal flaps when closed with the conventional silk sutures and N-butyl cyanoacrylate. MATERIALS AND METHODS: The study was carried out on 24 patients who needed flap surgical procedure for pocket therapy. RESULTS: It was found that healing with the cyanoacrylate is associated with less amount of inflammation during the first week when compared with silk. However, over a period of 21 days to 6 weeks, the sites treated with both the materials showed similar healing patterns. CONCLUSION: It can be concluded that cyanoacrylate aids in early initial healing.

Ganancia de inserción clínica en área de compromiso estético: caso clínico / Ganancia de inserção clínica em área de compromisso estético: caso clínico

Principios de regeneración guiada de tejidos fueron usados con el objetivo de conseguir eliminación de bolsa periodontal persistente luego de procedimientos de raspaje y aplanamiento radicular en área de incisivos centrales superiores. Durante la cirugía de este caso clínico se usó membrana de colágeno y hueso liofilizado bovino; fue lograda la eliminación de la bolsa así como una considerable ganancia de inserción, durante un período de observación clínica y radiográfica de 8 meses. Junto con el relato del caso clínico, se discuten las indicaciones de este tipo de cirugía en áreas de comprometimiento estético

Avaliaçäo quantitativa da drenagem do exsudato de bolsas periodontais supra-ósseas antes e após a aplicaçäo do raio laser Ga As 904nm: estudo em humanos / Quantitiative evaluation of exsudate drainage of suprabony periodontal pockets before and after the application of laser Ga As 904nm: study in humans

Os autores realizaram avaliaçäo eletrônica (Periotron) do volume de exsudato drenado de 30 bolsas periodontais, em humanos, antes e após a aplicaçäo da irradiaçäo Laser Ga As 904nm. Concluiram que esta drenagem aumentou consideravelmente depois da irradiaçäo. Sugerem que a laserterapia integre o elenco de técnicas constituintes dos procedimentos básicos na terapêutica periodontal

Imunodepósitos (IgA, IgM, C3 e CIq) na parede näo mineralizada da bolsa periodontal supra-óssea: estudo em humanos / Imunodeposits (IgG, IgM, C3 e CIq) in non-mineralized wall of suprabony periodontal pocket: study in humans

Estudou-se, pela técnica da IMFD, a localizaçäo e a distribuiçäo dos imunodepósitos de IgG, IgA, IgM, C3 e Clq em vinte fragmentos gengivais de vinte pacientes portadores de bolsa periodontal supra-óssea. Compararam-se entre si, as vertentes interna e externa da parede näo mineralizada da bolsa periodontal supra-óssea de cada caso. Tanto a resposta imune como a resposta inflamatória estiveram em maior intensidade na vertente interna, na maioria dos casos. Entretanto, em alguns, a näo observaçäo de imunodepósitos, apesar da identificaçäo de intenso infiltrado monuclear, sugere atuaçäo de mecanismos imunorreguladores locais que carecem de maiores investigaçöes

Estudo histopatológico da parede näo mineralizada da bolsa periodontal supra-óssea / Histopathological study on the demineralized wall of suprabony periodontal pocket

Estudos histopatológicos foram realizados em 30 fragmentos de gengiva humana a fim de verificar comparativamente as alteraçöes patológicas que ocorrem nas vertentes interna e externa da bolsa periodontal supra-óssea, assim como a intensidade e a natureza do infiltrado leucocitário. O material, após preparo histológico, foi analisado ao microscópio óptico. Observou-se como alteraçöes patológicas: degeneraçäo vacuolar, hipertrofia-hiperplasia, metaplasia (ceratinizaçäo do epitélio da bolsa periodontal), exulceraçäo, ulceraçäo e infiltraçäo leucocitária

Gengivectomia com o emprego da sonda demarcadora / Gingivectomy utilizing the demarcated probe

Foi estudada uma faixa de tecido gengival removida na gengivectomia, quando a incisão é realizada de 1 a 2 mm apical ao ponto determinado pelo uso da sonda demarcadora, tendo em vista que a profundidade da sondagem é influenciada por diferentes fatores, entre os quais, o estado do tecido, 28 biópsias obtidas de 21 pacientes de 13 a 46 anos de idade foram analisadas morfologicamente com a aplicação de um Indice Histológico Gengival (I.H.G.). Os resultados revelaram: em 68,86 por cento dos casos um I.H.G. = 0, em 32,14 por cento um I.H.G. = 1 relacionado com o ponto de demarcação e o fundo do sulco, e nenhuma evidência de I.H.G. mais elevados. Esses resultados indicam que a incisão realizada de 1 a 2 mm apical aos pontos sagrantes, leva à remoção de uma faixa de tecido gengival normal